Saturday, 31 January 2015

Next Tuesday MPs in the
House of Commons will be asked to vote to make Britain the first country in the
world to offer controversial ‘three-parent’ fertility treatments to families
who want to avoid passing on mitochondrial diseases to their children.

This is final crunch time so it’s not surprising that the
media is giving the debate high profile.

Earlier this week forty scientists from 14 countries urged
the British legislature to approve the new laws allowing mitochondrial DNA
transfer.

Yesterday the Anglican and Catholic Churches struck back criticising the
move on grounds of ethics, efficacy and safety.

Today the scientists have done
their usual retreat at such moments and accused the churches of ‘ignorance’:
‘The objections are all religious, they just don’t understand the science’.

But it’s precisely because the scientists have not effectively made their case
that Christians with science backgrounds are raising objections.

Over the last three years Christian Medical Fellowship – an
organisation with over 4,500 British doctors as members – has published over 20
articles (see here
and here)
raising serious questions not just about the ethics, but also about whether these techniques are safe, workable or even necessary.

We have also warned repeatedly about the dangers of these
techniques crossing two scientific rubicons in allowing both germline alteration (generationally transmissible
genetic modification) and also cell nuclear replacement.

These warnings have gone unheeded.

Most of the MPs who will be voting on Tuesday do not have
scientific backgrounds and are not experts in ethics – and will be basing their
votes on what they are being told by the scientific community.

There are about 50 known mitochondrial
diseases (MCDs), which are passed on in genes coded by mitochondrial
(as opposed to nuclear) DNA. They range hugely in severity, but for most there
is presently no cure and little other than supportive treatment.

It is therefore understandable that scientists and affected families want
research into these two related ‘three-parent embryo’ techniques (pronuclear
transfer and maternal spindle transfer) to go ahead.

But there are very good reasons
for caution.

This is not about finding a cure. It is about preventing people with MCD being
born. We need first to be clear that these new technologies, even if they are
eventually shown to work, will do nothing for the thousands of people already
suffering from mitochondrial disease or for those who will be born with it in
the future.

Furthermore four big questions remain: Is it safe? This is far from
established. Will it work? We remain deeply sceptical. Is it ethical? There are
huge ethical questions. Is it even necessary? There are actually already alternative
solutions available for affected couples including adoption and IVF egg
donation.

These technologies use similar ‘nuclear transfer’ techniques to those used in ‘therapeutic
cloning’ for embryonic stem cells (which has thus far failed to deliver) and
animal-human cytoplasmic hybrids (‘cybrids’).

The wild claims made about the therapeutic properties of
‘cybrids’ by the biotechnology industry, research scientists, patient interest
groups and science journalists back in 2008 duped parliament into legalising
and licensing animal human hybrid research.

Few now will remember Gordon
Brown’s empty promises in the Guardian on 18 May that year of
‘cybrids’ offering 'a profound opportunity to save and transform millions of
lives' and his commitment to this research as 'an inherently moral endeavour
that can save and improve the lives of thousands and over time millions of
people'.

That measure was supported in a heavily whipped vote as part
of the Human Fertilisation and Embryology Bill, now the HFE Act. But ‘cybrids’,
as we predicted at the time, are now a farcical footnote in history.

They have not worked and investors have voted with their
feet. Ironically, it was in that same Act of Parliament, that provision for
this new research was also made.

And yet it was the same scientists using much the same
arguments who were pushing it through then. Such a track record does not engender trust in their judgments, especially when one considers the deep ideological and financial vested interests involved.

I have a profound sense of déjà vu here. History will of
course prove who is right.

Friday, 30 January 2015

Following the attacks in Paris against the journal 'Charlie
Hebdo' on 7 January 2015 Christian evangelist Jay Smith decided to display and
discuss the controversial covers of the journal which provoked the violence.

So on 11 January in the most public of settings, and that bastion of 'Freedom of Speech' - the world famous Speaker's Corner in London - he showed covers which mocked not only Muhammad, but Jesus Christ as well and asked the (many)
Muslims in the crowd whether they were offended.

One of these covers mocking Christianity is I think the most
blasphemous illustration I have ever seen.

Not surprisingly the Muslims in the crowd were offended, as Jay himself was, but he used
the opportunity to make the point that whilst the covers were also grossly offensive
to Christians, Christ’s own response to mockery and derision was not violence
but rather to pray for his persecutors.

The video
is well worth viewing in its entirety – but I was particularly
struck by the section in which Jay explains what he considers to be the real
motivation behind the attack.

The real reason, he argues, was not the magazine covers per
se, but rather a series of comic books on the life of Muhammad by Stephane Charbonnier, the editor of the Charlie Hebdo journal, who was killed on 7 January. These comics are pictured on the video from 7m 40s and reproduced in the pictures on this blogpost..

Apparently
these are no longer available to buy and are likely to become collectors’ items
in the future.

As Jay
illustrates they are titled 'The Life of Mohammed' and depict episodes from the real life of Muhammad.

What
Charbonnier essentially did was to take the most 'juicy' stories from the Islamic
traditions. In fact

he claimed in January 2013 (see also numbered references below) that his work is 'a properly researched and educational worked prepared by an (unnamed) Franco-Tunisian sociologist'.

It
appears he used a variety of sources and may well have used Zakaria Botros as
his inspiration.

Botros
is a Coptic priest from Egypt who is best known for his
critiques of the Qur'an and other books of Islam.

According
to Wikipedia (see
links there) World Magazine gave Father Botros the ‘Daniel of the Year’
award in 2008 and he has been named ‘Islam's public enemy No. 1’ by Arabic
newspaper al Insan al Jadeed.Al-Qaeda has
apparently put a $60 million bounty on his head.

In
an interview with Aljazeera TV, Islamic cleric Ahmad al-Qatani stated
that some six million Muslims convert to Christianity annually, many of them persuaded
by Botros's public ministry.

According
to Botros, his analysis of Islamic scriptures is designed to give Muslims a ‘short,
sharp shock’, intended to make them ask questions and examine their faith.

However,
he contends that he is not attacking Islam, but merely searching for the truth;
‘The truth is not restricted to someone, but it belongs to everybody, and it is
the right of everybody to search for the truth and to embrace it without fear
of authorities or the terrorism of bigots.’

On 16
September 2012, the Los Angeles Times reported that Botros was an
ideological influence on the film Innocence of Muslims, whose portrayal of the
Prophet Muhammad set off protests and attacks on Western embassies across
the Middle East.

But
Botros has denied this on his own website.

Regardless,
as Jay points out, every story in Charbonnier’s comics is footnoted and sourced
to Muslim tradition – that is, every one actually appears in Islam’s own sacred
texts. In other words, Charbonnier was simply illustrating what the Hadith already
teaches about the prophet.

But the
key point is this – most Muslims do not know their own religious texts well
enough to know that. And perhaps if they did they would be asking the same
questions as the six million per year allegedly influenced by Botros.

So
there it is. Take it or leave it (but if you doubt me look at the references below).

I don’t imagine that many newspapers will be reproducing these comics and I certainly do not own copies myself.

This week has seen two significant anniversaries that have
revived memories of the Second World War, and in particular what Britain was
spared from.

First was the 50th anniversary of the death of
the great wartime British Prime Minister Winston Churchill on 24 January 1965.

Second was the 70th anniversary of the liberation
of prisoners from the Auschwitz-Birkenau concentration camp – Holocaust
Memorial day. More than one million people, mostly Jews, died at the Nazi camp
(pictured) before it was liberated by allied troops on 27th January
1945.

Earlier this week a Jewish figurehead sparked
controversy by suggesting that new draft legislation seeking to
decriminalize assisted suicide in Scotland is based on similar principles to
racist Nazi laws that paved the way for the Holocaust.

Ephraim Borowski,
director of the Scottish Council of Jewish Communities, spoke out against Patrick
Harvie’s Assisted Suicide Bill which is currently making its way through
Holyrood in an evidence session with MSPs.

He referred to Holocaust
Memorial Day to make ‘a point about practicalities rather than principles’ and
added: ‘It's now a well-known cliche that the Holocaust didn't begin in
Auschwitz, it ended in Auschwitz. In terms of principle, it began with the
belief that some lives are not worth as much as others, and that is precisely
what we are faced with here.’

Understandably his claims have elicited appeals to ‘Godwin’s law’ - an adage asserting that ‘As an online
discussion grows longer, the probability of a comparison involving Nazis or
Hitler approaches 1’.

But rather than dismissing Borowski’s comparison out of hand critics should
spend some time examining the historical evidence-base behind it because it is
considerable.

The horrific genocide of six million Jews was in fact only
the final chapter in the Nazi holocaust story.

The detail of how it happened, and particularly the role
of doctors in the process, is not at all well known.

What ended in the 1940s in the gas chambers of Auschwitz,
Dachau and Treblinka had much more humble beginnings in the 1930s in nursing
homes, geriatric hospitals and psychiatric institutions all over Germany.

When the Nazis arrived, the medical profession was ready and waiting.

Twenty three physicians (see below) were tried at the so-called Nuremberg
Doctors' Trial in 1946, which gave birth to the Nuremberg Code of ethics
regarding medical experiments.

Many others including some of the very worst offenders never
came to trial (see list of main perpetrators here and
full list here)

How did it actually happen?

Our story begins with Germany emerging from the First World War defeated,
impoverished and demoralised.

Into this vacuum in 1920 Karl Binding, a distinguished lawyer, and Alfred
Hoche, a psychiatrist, published a book titled ‘The granting of permission for
the destruction of worthless life. Its extent and form'.

In it they coined the term ‘life unworthy of life’ and argued that in certain
cases it was legally justified to kill those suffering from incurable and
severely crippling handicaps and injuries. Hoche used the term
ballastexistenzen (‘human ballast’) to describe people suffering from various
forms of psychiatric disturbance, brain damage and retardation.

By the early 1930s a propaganda barrage had been launched against traditional
compassionate 19th century attitudes to the terminally ill and when the Nazi
Party came to power in 1933, 6% of doctors were already members of the Nazi
Physicians League.

In June of that year Deutsches Arzteblatt, today still the most respected and
widely read platform for medical education and professional politics in
Germany, declared on its title page that the medical profession had
‘unselfishly devoted its services and resources to the goal of protecting the
German nation from biogenetic degeneration’.

From this eugenic platform, Professor Dr Ernst Rudin, Director of the Kaiser
Wilhelm Institute of Psychiatry of Munich, became the principle architect of
enforced sterilisation. The profession embarked on the campaign with such
enthusiasm, that within four years almost 300,000 patients had been sterilised,
at least 50% for failing scientifically designed ‘intelligence tests’.

By 1939 (the year the war started), the sterilisation programme was halted and
the killing of adult and paediatric patients began. The Nazi regime had
received requests for ‘mercy killing’ from the relatives of severely
handicapped children, and in that year an infant with limb abnormalities and
congenital blindness (named Knauer) became the first to be put to death, with
Hitler’s personal authorisation and parental consent.

This ‘test-case’ paved the way for the registration of all children under three
years of age with ‘serious hereditary diseases’. This information was then used
by a panel of ‘experts’, including three medical professors (who never saw the
patients), to authorise death by injection or starvation of some 6,000 children
by the end of the war.

Adult euthanasia began in September 1939 when an
organisation headed by Dr Karl Brandt and Philip Bouhler was set up at
Tiergartenstrasse 4 (T4) (pictured left The aim was to create 70,000 beds for
war casualties and ethnic German repatriates by mid-1941.

All state institutions were required to report on patients who had been ill for
five years or more and were unable to work, by filling out questionnaires and
chosen patients were gassed and incinerated at one of six institutions (Hadamar
being the most famous).

False death certificates were issued with diagnoses appropriate for age and
previous symptoms, and payment for ‘treatment and burial’ was collected from
surviving relatives.

The programme was stopped in 1941 when the necessary number of beds had been
created. By this time the covert operation had become public knowledge.

The staff from T4 and the six killing centres was then redeployed for the
killing of Jews, Gypsies, Poles, Russians and disloyal Germans. By 1943 there
were 24 main death camps (and 350 smaller ones) in operation.

Throughout this process doctors were involved from the earliest stage in
reporting, selection, authorisation, execution, certification and research.
They were not ordered, but rather empowered to participate.

Leo Alexander (right), a psychiatrist with the Office of the Chief of Counsel
for War Crimes at Nuremberg, described the process in his classic article 'Medical Science
under Dictatorship' which was published in the New England Medical
Journal in July 1949.

‘The beginnings at first were merely a subtle shift in emphasis in the basic
attitude of the physicians. It started with the attitude, basic in the
euthanasia movement that there is such a thing as a life not worthy to be
lived. This attitude in its early stages concerned itself merely with the
severely and chronically sick. Gradually the sphere of those to be included in
this category was enlarged to encompass the socially unproductive, the
ideologically unwanted, the racially unwanted and finally all
non-Germans.’

The War Crimes Tribunal reported that ‘part of the medical profession
co-operated consciously and even willingly’ with the ‘mass killing of sick
Germans’.

Among their numbers were some of the leading academics and scientists of the
day; including professors of the stature of Hallervorden (neuropathology),
Pernkopf (anatomy), Rudin (psychiatry/genetics), Schneider (psychiatry), von
Verschuer (genetics) and Voss (anatomy). None of these men were ever prosecuted
while of the 23 defendants at Nuremberg, only two were internationally
recognised academics.

It is easy to distance ourselves from the holocaust and those doctors who were
involved. However, images of SS butchers engaged in lethal experiments in
prison camps don’t fit the historical facts; the whole process was orchestrated
through the collaboration of internationally respected doctors and the State.

With the advantage of hindsight we are understandably amazed that the German
people and especially the German medical profession were fooled into accepting
it. The judgement of the War Crimes Tribunal in 1949 as to how they were fooled
was as follows.

'Had the profession taken a strong stand against the mass
killing of sick Germans before the war, it is conceivable that the entire idea
and technique of death factories for genocide would not have materialized...but
far from opposing the Nazi state militantly, part of the medical profession
co-operated consciously and even willingly, while the remainder acquiesced in
silence. Therefore our regretful but inevitable judgement must be that the
responsibility for the inhumane perpetrations of Dr Brandt (pictured
left)...and others, rests in large measure upon the bulk of the medical profession;
because the profession without vigorous protest, permitted itself to be ruled
by such men.' (War Crimes Tribunal. 'Doctors of Infamy'. 1948)

The British Medical profession and the Holyrood parliament need to take note.

The Government’s Counter-Terrorism and Security Bill, currently being
considered by the House of Lords, places a duty on specified authorities,
including universities, to ‘have due regard to the need to prevent people from
being drawn into terrorism’.

Who could possibly object to that, you might ask.

But in a Britain where rising state intrusion and the steady march of
political correctness make frightening bedfellows eternal vigilance is required
to preserve basic freedoms. And there is
real cause for concern here.

Official
guidance out for consultation – which closes today - sets out the
Government’s view that the promotion of ‘non-violent extremist views’ is a
major way individuals are drawn into terrorism.

But it defines extremism as ‘vocal or active opposition to fundamental
British values, including democracy, the rule of law, individual liberty and
mutual respect and tolerance of different faiths and beliefs’.

The problem is that these very same terms have already been used in
various contexts to restrict and stifle orthodox Christian beliefs and
behaviours such as opposition to abortion, protection of marriage as a lifelong
commitment between a man and a woman, prayer, wearing of religious symbols and
the preaching of the Gospel . The fact is that some people regard such
Christian beliefs and behaviours as offensive and intolerant.

The guidance says universities should have policies
in place for dealing with external speakers, such as ‘advance notice of the
content of the event, including an outline of the topics to be discussed and
sight of any presentations, footage to be broadcast etc’.

It adds that Universities should also have at least
14 days’ notice of the event ‘to allow for checks to be made and cancellation
to take place if necessary’.

CMF has responded to the consultation today to
express its concerns.

Whilst we affirm the importance of free speech on
campus, and recognise the potential risk of misuse of higher education
institutions as platforms for drawing people into terrorism, we are also concerned
that the guidance as currently drafted would have a chilling effect on free
speech and freedom of association, wholly disproportionate to its impact on the
prevention of terrorism.

Of particular concern are the draft recommendations on ‘Speakers and
Events’ (paragraphs 64-71). The draft rightly notes (paragraph 65) the duty of
the university to ensure freedom of speech. However we see the provisions
expected in paragraph 66 as being incompatible with ensuring freedom of speech.

Fourteen days’ notice for booking a speaker for an event is impractical
for a student society such as a Christian Union that may well have an external
speaker visiting every week, and where last minute changes are sometimes
necessary. A small group of Christian medical students might well arrange for a
local doctor to join them for a meeting on campus to discuss an ethical issue
at short notice. Such events would appear to be banned by this guidance. What
about a long planned event where a speaker is unwell the day before, and a
replacement is brought in?

Submission of content for such an event would restrict the nature of
events on campus. If a debate or discussion is held, it may be very difficult
to know the exact content of such an event in advance. Is such debate to be
stifled?

Institutions of higher education
will not want to see their students cloistered as a result of an overprotective
bureaucracy, which places unreasonable demands on many perfectly legitimate
outside speakers who will be effectively censored. This
guidance will perhaps unintentionally lead to an increasingly
narrow spectrum of views being represented and debated on campus. Without
exposure to a broad range of views and healthy debate, how can students
choose their worldview in the marketplace of ideas, fight extremism and prepare
for life beyond study?

‘A system for assessing and rating risks’ for such events is likely to
be bureaucratic in the extreme, and expose small student societies to large
amounts of paperwork, simply to be able to have any external speaker at their
event.

We would urge that the specifics of these draft regulations be
reconsidered.

Friday, 16 January 2015

As 2015 dawns, pause with us to reflect on an
extraordinary year. Despite the many challenges presented, 2014 was a year
when, despite many pressures, those at the heart of this debate stood up and
dared to say 'no'. It was the year when what proponents of assisted suicide
have tried to sell as agreed wisdom was questioned, doubted and often dropped.
We look forward to pressing on with you now (Care Not Killing Alliance)

We are all quite used to polls which appear to suggest high
levels of public support for a change in the law with much effort going into
suggesting that irreversible suffering at the end of life is the rule, not the
exception. 2014 saw that perceived wisdom more widely doubted. First, we saw a
drop in the level of support for a change in Scottish law, back in January.
Then, on the day of the Falconer Bill's second reading, a ComRes poll
commissioned by a CNK member organisation found that support
for the Assisted Dying Bill plummeted when the reality of legal change and
what it would mean for terminally ill and disabled people, and for the practice
of medicine.

Perhaps the most
dramatic expressions of changing public opinion were found in a further ComRes
poll in November, forcing many to consider the context in which legalised
assisted suicide would exist: more than four in 10 believe assisted suicide
will be extended beyond the terminally ill if the current law is changed; a
clear majority of the public says there is no safe system of assisted suicide;
and fewer than three in 10 believe changing the law on assisted suicide will
not lead to increase in abuse of vulnerable people.

Doctors

Flawed safeguards in the Falconer and MacDonald Bills caused
legal
experts to deem the draft legislation unsatisfactory even where they
accepted principles to which the medical profession has remained overwhelmingly
opposed. Key healthcare professionals' bodies were clear
in their message to peers in July, and the Royal Colleges of General
Practitioners and Physicians
both conducted surveys of members, with the response being clearly in favour
not only of continued opposition to a change in the law which would
fundamentally alter the practice of medicine, but also in favour of continued collegiate
opposition. Indeed, there has been a move against isolated but well-placed
advocates of legal change who continue to demand that their views be accepted
by the majority. This was particularly felt first at
the BMA's ARM, and then later when the editorial
team of the British Medical Journal sought to use the publication to
advance the 'assisted dying' cause. Healthcare professionals are under no
illusions: it is
never 'just about the debate'.

The reality of death and dying can never be far away in the
debate on assisted suicide and end of life care, and 2014 saw the death of,
among others, two people who were totally committed - to two very different
points of view. Jim Dobbin
MP, grandfather to two disabled grandchildren, was passionately opposed to
the 'counsel of despair' inherent in all assisted suicide/euthanasia proposals,
and his work in this area should continue to inspire parliamentarians.
Independent MSP Margo
MacDonald, meanwhile, the prime mover for assisted suicide in Scotland,
died of natural causes in the Spring, with her bill being taken up by a Green
colleague.

Remaining challenges

The combined threats in Westminster and Holyrood of the
Falconer and MacDonald Bills continue to stalk end of life care, and will loom
large in 2015.

Consideration
of the Falconer Bill in committee
will resume in January; have you read the guides
circulated by CNK among members of the House of Lords?

Oral
evidence will shortly be taken in relation to the Assisted Suicide
(Scotland) Bill, and CNK will be among the contributors. Have you read our
earlier, written
submission?

The
effect of a recent change
to prosecution guidelines in England and Wales, highlighted at the
time by CNK, remains to be seen, but we will continue to monitor this
closely.

As a
nation, we remain, quite simply, bad
at talking about death. This is a debate often framed as being about
'choice', but patients and families are already able to empower
themselves, provided that they are offered the right support, educate
themselves - and discuss openly their hopes and fears. We are at our
strongest when we are honest with others and when we are prepared to
accept support from others just as we have ourselves supporters others. Is
end of life care the elephant in the room for you? Begin the conversation
today.

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Kiwi, Christian and Medical

This blog deals mainly with matters at the interface of Christianity and Medicine. But I do also diverge into other subjects - especially New Zealand, rugby, economics, developing world, politics and topics of general Christian and/or medical interest. The opinions expressed here are mine and may not necessarily reflect the views of my employer or anyone else associated with me.

About Me

I am CEO of Christian Medical Fellowship, a UK-based organisation with 4,500 UK doctors and 1,000 medical students as members. The opinions expressed here however are mine, and may not necessarily reflect the views of CMF or anyone else associated with me.